1058 LITTLE CYPRESS KEY - ROOF ; CITY OF ATLANTIC BEACH
• "' SJ 800 SEMINOLE ROAD
15, ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2363
Job Type: ROOF PERMIT
Description: RE-ROOF SHINGLES
Estimated Value: $8,500.00
Issue Date: 10/7/2015
Expiration Date: 4/4/2016
PROPERTY ADDRESS:
Address: 1058 LITTLE CYPRESS KEY
RE Number: 172027-5818
PROPERTY OWNER:
Name: FARGO, WELLS
Address: ONE HOME CAMPUS MAC X2301 03R
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone: - -
FEES:
BUILDING PERMIT FEE $92.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $96.50
PERMIT IS APPROVED ONLY IN ACCORDANCE Val I ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845 ( 5 -Roo F- Z 3 G 3
Job Address: tO5q. C\-\-k\-t, CyQSS ' C") fW 1.OA*t . vf g, Permit Number:
Legal Description 4lk.LQ0 0-2S-- 'S JC& Lcualoo 1 mk 3 Parcel# Sq.Ft
Floor Area of . ,\ q. t. q•
Valuation of Work$ . r Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Cr Move Demolition pool/spa window/door
Use of existing/proposedstructure(s)(circle one): Commercial Re de '.l
i
If an existing structure,is a fire sprinkler system installed? (Circle one): es No Kip
Florida Product Approval# IO.7-k - `(CIS \%' sts1 —zc •For multiple products use product approvelform r
Describe in detail the type of work to be performed: ,I�e � 3\9 (0112, S le
Property Owner Information: �p�� �J�
Name: 14d (1 Address:�U L *k\ albyfe<5 _.
City Lot,.A ■ 4,..' . v State 1t.Zip 37.233 Phone_10 -LO '
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 1 L. At..i. A .. Qualifying Agent: T2611.)6 S
Address:' • 0 MatinAIRMILIMErail City Jag State _ Zip . 2 Z 1(P
Office Phone .Ok11"17< Job Site/Contact Number IS.3E5.' t(f Fax# SttQ(Q--14C.0 -(.&"4-0
State Certification/Registration# CCC 13'1 .0'1"1
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becoes null
and work is commenced.o menced.not I understand that separate permits or must be secured for Electrical-Work,Plumbing,S gns,a Wells,Pools, Furnaces,aces,Boileis,time eaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cahcel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner 6 //i- r Signature of Contractor
Print Name Print Name -1 1"61`+v\s SVA,MVt /..... ..._...�
r.. l.�.�d C7
Sworn to and subscribed before me Sworn to and subscribed before me
this i D¢y of 6, - v- 20 . this _. Day o; 'At _il 20 *S
1 a. t ( 1
:.t ' Nlmb Ras Basch _ r-
N ry Public "'t' M
� NOTARY PUBLIC :* *IL*Y
STATE OF FLORIDA ,'1� NIIMy P IIC-SW afdlwa 1 1.26.10•Canal FF226733 M,Cesm EIWMM Jr IA.NI
Expires 5/4/2019 ''-�_.a,
i' CMniNww ION:MMi
Doc # 2015223962, OR BK 17318 Page 2309, Number Pages: 1 , Recorded
09/30/2015 at 12:21 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.___-. •__ .
County of_..Duval _... ....____-••
To Whom It May Conccrtt
The undersigned hereby informs you that improvements will be made TO certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
NC3 MENT.
Legal Description of property being improved: 44-60 17 2S:29E Selva Lakes Unit 3
Address of property being iiixtpx}ov,d: 1058 Little Cypress Key Atlantic Beach FL 32233
General description of improvemments:: Reroof
Ronald Floyd ddress: 1058 Little Cypress Key Atlantic Beach FL 32233
Owner:
Owner's interest in site of the improvement:..._:... •^..."....._:.—...
Fes;Simple Titleholder(if other than owner): ---......................._.. _.._ _�- - -Name:
Contractor: Great White Construction _-
Address: 4320 Deerwood Lake Pkwy#403 Jacksonville FL 32216
Telephone No.: 647-7725 Fax No: 866-746-1840
Surety(if any) _• _ �. _..._...__.
Address; _ - Antonin of Bond$
Telephone No: Fax No:
Name and address of any person making a ban for the construction of the improvements
Name:
Address: _- _.._. . ..:..._.:. _........:.:...:.. - W
Phone No: Fax No:
Name of person within the State of Florida;other than himself;designated by owner upon whim.notices or other documents may be
served: Name
Address:
Telephone No: Fax No:
in addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
113.06(2)(b),Florida Statues. (Fill in at Owner's option;
Name: -Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
november..30,2015 ------
TIUS SPACE FOR RECORDER'S USE ONLY OWNER , c
Signed DC'"
Before me this :_ day of in the plumy of i)uva1,State
Of I loridi has personally appeared ;< r
Nolan.Pull€ie at Large,Sode oi"Florida.County of Duval.
�?ty camrriissiiin c;xpires:
sK +
woe Real tataac8
Per t o i ly Known: or
i'roduccd tdcraification:
NOTARY PUBLIC,..STATE OF FLORIDA
Coaroni#5.F23575.3
E.A' W.514.1201